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目的探讨实时超声造影定量分析技术评价大鼠肝纤维化病理分期的价值。方法 44只大鼠制作肝纤维化模型,6只大鼠作为对照组。于造模的4、8、12周分别随机从造模组取12只,从对照组中取2只行超声造影检查,获得以下参数:造影剂到达肝动脉、门静脉、肝静脉时间(HAAT、PVAT、HVAT);肝实质及门静脉灌注参数:峰值强度(LP_(PI)、PV_(PI))、达峰时间(LP_(TP)、PV_(TP))、曲线尖度(LP_β、PV_β)、曲线下面积(LP_(AUC)、PV_(AUC));计算出肝动脉-肝静脉、门静脉-肝静脉渡越时间(HA-HVTT、PV-HVTT),门静脉-肝实质峰值强度差(δPI),肝实质-门静脉达峰时间差(δTP)。分析对照组及造模组肝纤维化各期定量参数的变化情况。结果 HVAT、PV-HVTTT、HA-HVTT、LP_(PI)、LP_(TP)、δPI、δTP差异有统计学意义(P<0.05),其余参数均无统计学意义。LP_(TP)、δTP对纤维化分期的鉴别能力较好,S≥S_2、S≥S_3、S≥S_4时,曲线下面积分别为0.812、0.860、0.822和0.808、0.857、0.856。结论实时超声造影定量分析对肝纤维化分期评估有一定价值。
Objective To investigate the value of quantitative real-time contrast-enhanced ultrasound in the evaluation of pathological stage of liver fibrosis in rats. Methods Forty-four rats were made into hepatic fibrosis model and six rats served as control group. At the 4th, 8th and 12th week of modeling, 12 rats were randomly selected from the model group and 2 from the control group. Contrast - enhanced ultrasound was used to obtain the following parameters: time to reach the hepatic artery, portal vein and hepatic vein (HAAT, PVAT and HVAT), hepatic parenchyma and portal vein perfusion parameters: peak intensity (LP PI, PV PI), peak time (LP TP, PV TP), curve sharpness (LP β, PV β) (LP_ (AUC) and PV_ (AUC)) were calculated. The peak values of hepatic artery-hepatic vein, portal vein-hepatic vein transit time (HA-HVTT, PV-HVTT) , Hepatic parenchyma-portal vein peak time difference (δTP). The changes of quantitative parameters of liver fibrosis in control group and model group were analyzed. Results The differences of HVAT, PV-HVTTT, HA-HVTT, LPI, LPP, δPI and δTP were statistically significant (P <0.05), and the other parameters were not statistically significant. The discriminant ability of LP_ (TP) and δTP for fibrosis staging was better, and under the condition of S≥S_2, S≥S_3, S≥S_4, the area under the curve were 0.812,0.860,0.822 and 0.808,0.857,0.856, respectively. Conclusion Real-time quantitative contrast-enhanced ultrasound has some value in staging evaluation of liver fibrosis.